Departament d'Enginyeria Informàtica i Matemàtiques, Universitat Rovira i Virgili, Av Països Catalans 26, Tarragona, Catalunya, Spain.
Abdominal Wall Surgery Unit, Department of General Surgery, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.
Sci Rep. 2022 Mar 3;12(1):3545. doi: 10.1038/s41598-022-07555-z.
An ostomy is a surgical procedure by which an artificial opening in the abdominal wall, known as a stoma, is created. We assess the effects of stoma location on the abdominal wall mechanics. We perform three-dimensional finite element simulations on an anatomy model which was generated on the basis of medical images. Our simulation methodology is entirely based on open source software. We consider seventeen different locations for the stoma incision (trephine) and we simulate the mechanical response of the abdominal wall when an intraabdominal pressure as high as 20 kPa is applied. We focus on factors related to the risk of parastomal hernia development such as the deformation experienced by the abdominal wall, the stress levels supported by its tissues and the corresponding level of trephine enlargement. No significant dependence was found between stoma location and the levels of abdominal wall deformations or stress supported by tissues, except for the case with a stoma located on the linea alba. Trephine perimeter and area respectively increased by as much as [Formula: see text] and [Formula: see text]. The level of trephine deformation depends on stoma location with considerably higher trephine enlargements found in stomas laterally located with respect to the rectus abdominis muscle.
造口术是一种通过在腹壁上创建人工开口（称为造口）的外科手术。我们评估造口位置对腹壁力学的影响。我们基于医学图像生成的解剖模型上进行三维有限元模拟。我们的模拟方法完全基于开源软件。我们考虑了造口切口（环钻）的十七个不同位置，并模拟了当腹腔内压力高达 20 kPa 时腹壁的机械响应。我们关注与发生侧凸疝风险相关的因素，例如腹壁的变形、其组织支撑的应力水平和相应的环钻扩大程度。除了位于白线的造口外，造口位置与腹壁变形或组织支撑的压力水平之间没有发现明显的相关性。环钻周长和面积分别增加了高达[公式：见正文]和[公式：见正文]。环钻的变形程度取决于造口位置，相对于腹直肌横向定位的造口，环钻的扩张程度明显更高。
